Caroline Baltzer, Ph.D. Clinical Psychologist

Payment for services is important in any professional relationship, particularly in therapy, as it demonstrates commitment to your treatment. The payment for appointments is expected at the time of service as per the Patient Payment Information and Agreement Form. Dr. Baltzer will then give you a monthly bill which you may submit to your insurance company for partial reimbursement directly to you if you are choosing to use your insurance benefits. If your insurance plan has “Out of Network Benefits” then you will be able to submit your claims for reimbursement. Dr. Baltzer is not on any HMO panels, and therefore you will not be able to be reimbursed for your treatment if you have an HMO. It is the patient’s responsibility to contact their insurance company to determine what their benefits are prior to beginning treatment. It is always and solely the patient’s responsibility to pay for services rendered, and if you are using insurance to ensure that he or she has an insurance plan that will reimburse them for treatment with Dr. Baltzer.

The charge for an initial diagnostic evaluation is $600; a 50-minute session is $300; 75-minutes is $450; 90-minutes is $525; and 2 hours is $700. Clinical Administration including phone calls, emails, and communication with treatment team members is billed in 15-minute increments at $75 per increment. Please note, if you are using insurance, Clinical Administration is deemed a “non-covered service” and they will not reimburse you for these charges. Other examples of Clinical Administration include communication with or reports to your insurance company, hospital visits, formally arranged consultations with other therapists, court-related services, treatment team meetings or consultations, and calls related to collateral treatment or services. Some services may require payment in advance.

There is a firm 48-hour cancellation policy, or the full fee will be charged.

Dr. Baltzer accepts personal checks, cash, and credit cards.

Dr. Baltzer complies with the Privacy Rules established under HIPAA, the Health Insurance Portability and Accountability Act. The Notice of Privacy Practices describes how medical information about you may be used and disclosed, and how you can get access to this information. It is given to all new patients, and a copy is available upon request.

About Confidentiality

Psychological services are best provided in an atmosphere of trust. You can expect your therapist to be honest with you about your problems and progress. You are expected to be honest about your expectations for services, your compliance with medication, and any treatment interfering behaviors.

It is your legal right that sessions and records about you be kept private. You will be asked to sign a release of information form before your therapist can talk about you or send records to anyone else. Without your signature, your clinician will not even reveal that you are receiving treatment from him/her.

In all but a few rare situations, your confidentiality (that is, your privacy) is protected by state law and by the rules of the profession. Here are the most common cases in which confidentiality is not protected:

1. If you were sent to your therapist by a court for evaluation or treatment, the court expects a report. If this is your situation, please talk with your therapist before saying anything you do not want the court to know. You have a right to share only what you are comfortable sharing.

2. If you are suing someone or being sued, or if you are being charged with a crime, then your therapist may be ordered to show the court your records. Please consult your lawyer about these issues. In the rare situation where clinical information is provided for legal purposes, it will be charged at a different rate; please discuss this with your lawyer or your therapist. If you are involved in a custody suit, your therapist will not testify in court regarding these matters. You must hire a separate clinician for any evaluation related to custody matters. This allows the therapy relationship to maintain its integrity by avoiding dual roles of the therapist, and prevents biased opinion.

3. If you make a serious threat to harm yourself or another person, the law requires your therapist to attempt to protect you or that other person. This usually means telling others, such as the police, about the threat.

4. If your therapist believes a child or an elder they hear about has been or will be abused or neglected, they are legally mandated to report this to the authorities.

When your therapist is on vacation, or otherwise unable to cover their practice, they will have a trusted fellow therapist cover for them. This therapist would be available to you in the case of an emergency, or as otherwise arranged. Therefore, he or she will need to know a certain amount of clinical information about you. Generally, your therapist will only tell the covering clinician what they need to know for an emergency. Of course, this covering therapist is bound by the same laws and rules to protect your confidentiality, as well as their limits.

Your therapist may sometimes consult other colleagues about clients to help ensure quality treatment, this is called collegial consultation and is the standard of practice, encouraged and considered essential for good treatment. These persons are also required to keep your information private but your name or other identifying information will never be given to them, and they will only be told as much as they need to know to be helpful.

Except for the situations described above, your therapist will always protect your privacy. It is also important that you not disclose the name or identity of any other patient that you may see or know in the office.

If your records need to be seen by another professional, or anyone else, your therapist will discuss it with you, and if you want to share these records, you will need to sign a release of information form. This form states exactly what information is to be shared, with whom, and why, and it also sets time limits for the permission.

If you are participating in couples or family therapy where there is more than one person in the therapy, and someone wants their record sent to anyone, all of the adults present in the therapy would have to sign a release form.

If you have questions or concerns at any time about the protocols of treatment or your confidentiality please bring these up with your therapist.